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Individual

MR. LEE ALLEN DENNIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
(504) 842-9119
Mailing address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP07893
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01633358
MS
05
2371207
LA
Enumeration date
07/19/2014
Last updated
11/10/2014
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